Croatian physicians’ and nurses’ experience with ethical issues in clinical practice

Abstract

Similar ethical difficulties are present in the clinical practice of both physicians and nurses, with important differences in access and use of ethics support services. A need for systematic ethics educational activities was identified. Inclusion of individual ethics consultants in Croatian healthcare ethics support services is strongly advised.

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources

“…Nurses are unable to influence the patient care process, and they must adapt to others' decisions with an attitude of conformism and a lack of autonomy. 9,18 In addition, the scarcity of resources, which affects care choices, suggests a conflict between patients' rights to proper care and economic performance needs of the structures that provide that care. Nurses increasingly require managerial skills to negotiate this conflict.…”

“…The results confirm what has emerged in other studies: basic, post-basic and continuing education on ethical issues and ethical competence have a pivotal role in increasing self-confidence in decision-making and in the use of available resources. [8][9][10]30 Conclusion With different intensities, all nurse respondents experienced ethical problems in the professional field. The most frequently detected problem (32.9%) was related to the self-determination of the patient with respect to the available treatments.…”

“…10 Although many studies on the propensity to use consultation services in European countries involve only physicians, 1,2,5 studies comparing physicians and nurses show that nurses assign less importance to ethics consultation services. [8][9][10] This may be a consequence of the prevailing model of the professional subordination of nurses compared to physicians, which implies that nurses perceive less need for ethical support. [8][9][10] Instead, the high frequency of critical situations in nurses' work underlines the importance of training and consultation support in furthering the development of ethical skills and judgments in nursing.…”

“…[8][9][10] This may be a consequence of the prevailing model of the professional subordination of nurses compared to physicians, which implies that nurses perceive less need for ethical support. [8][9][10] Instead, the high frequency of critical situations in nurses' work underlines the importance of training and consultation support in furthering the development of ethical skills and judgments in nursing. 11 Studies that have described the development of ethics services, including the experience of ethical issues and the propensity to use ethics consultation services, have also highlighted how these factors can be different in each country.…”

“…While ethical issues are present in many health school programmes, several studies highlight how basic and lifetime learning in ethics are poorly diffused among healthcare workers. 8,9 Consequently, attitudes about recurring ethical training are hampered by the poor diffusion of ethics consultation services and the poor awareness of care workers about the importance of ethical problems. 1 Education about these issues leads to a higher preference for ethics consultation, and education reinforces the confidence among nurses and physicians about their abilities to face ambiguous and critical ethical situations in patient care.…”